Muhteşem GEDİZLİOĞLU, Selda ARI, Işıl Y. BOZDAĞ, Can Ahmet KULAN, Zehra ADIBELLİ

THE EFFECT OF FROVATRIPTAN ON RENAL BLOOD FLOW DYNAMICS IN MIGRAINE PATIENTS

Introduction: Ischemic complications of triptans are rarely described in kidneys. However, their vasoconstrictive effect is much weaker than cerebral and coronary arteries. The aim of this study is to investigate the effect of frovatriptan on renal hemodynamics in adult migraineurs. Material and Method: Renal arterial blood flow was evaluated using doppler ultrasonography in 35 migraineurswith a mean age of 33, at a time point after at least one week without a migraine headache. Resistivity and pulsatility indexes, and acceleration time were calculated including peak systolic, end diastolic and mean blood flow velocities of renal interlobar arteries. Systolic, diastolic, and mean arterial blood pressures, blood urea nitrogen and creatinine were estimated. All tests were repeated during a migraine attack 2-24 hours after ingestion of a single dose of frovatriptan 2.5 mg. The results were statistically compared. Results: No difference was found between pre- and post-frovatriptan doppler parameters. Blood pressures and biochemical values were also similar in pre- and post-frovatriptan estimations. Conclusion: The reports of renal infarction due to triptans may imply a safety issue. Here, we investigated renal arterial haemodynamics under the effect of frovatriptan. No meaningful doppler alteration was found. To our opinion, the safety concern of frovatriptan is mostly limited to the cardiovascular system.

MİGREN HASTALARINDA FROVATRİPTANIN RENAL KAN AKIMI DİNAMİKLERİ ÜZERİNE ETKİSİ

Giriş: Triptanlar nadiren böbreklerde iskemik infarkta yol açabilirler. Ancak buradaki vazokonstriktif etkileri koroner ve serebral arterlerdekinden çok daha zayıftır. Bu çalışmanın amacı erişkin migrenlilerde frovatriptanın böbrek arterleri üzerine etkisini araştırmaktır. Gereç ve Yöntem: Bu çalışmada ortalama yaşı 33 olan 35 migren hastasında (30 kadın), baş ağrısız ve bir antimigren ilacının içilmiş olmadığı en az 1 haftalık bir süre sonunda renal doppler uygulanarak böbrek arteriyel akımı değerlendirildi. Rezistivite ve pulsatilite indeksleri ile akselerasyon zamanı ve renal interlobar arterlerin tepe sistolik, son diastolik ve ortalama kan akım hızları hesaplandı. Sistolik, diyastolik ve ortalama arteriyel kan basınçları ile serum üre ve kreatinin değerleri ölçüldü. Tüm testler yeni bir migren atağında tek doz 2.5 mg frovatriptan alımını izleyerek 2-24 saat içinde tekrarlandı. Sonuçlar istatistiksel olarak karşılaştırıldı. Bulgular: Frovatriptan öncesi ve sonrası doppler ultrasonografi parametreleri arasında istatistiksel fark bulunmadı. Kan basınçları ve biyokimyasal sonuçlar arasında da anlamlı bir fark yoktu. Sonuç: Triptanlara bağlı böbrek iskemisi olguları triptanların güvenliği hakkında bir kuşku yaratabilir. Bu çalışmada frovatriptan etkisiyle böbrek arteriyel akım değişiklikleri araştırıldı. Doppler parametrelerinde anlamlı bir değişiklik gösterilemedi. Böylece bilinen periferal vasküler hastalığı olmayan bireylerde frovatriptana ilişkin güvenlik kaygılarının kardiyovasküler sistem ile sınırlı olduğu söylenebilir.

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